Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980�2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1�4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980�2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age�sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5·8 million (95 uncertainty interval UI 5·7�6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7�53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3�43·6) to 2·6 million (2·6�2·7) neonatal deaths and 47·0% (35·1�57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6�3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

Evolution patterns and parameter regimes in edge localized modes on the National Spherical Torus Experiment

We implement unsupervised machine learning techniques to identify characteristic evolution patterns and associated parameter regimes in edge localized mode (ELM) events observed on the National Spherical Torus Experiment. Multi-channel, localized measurements spanning the pedestal region capture the complex evolution patterns of ELM events on Alfven timescales. Some ELM events are active for less than 100~microsec, but others persist for up to 1~ms. Also, some ELM events exhibit a single dominant perturbation, but others are oscillatory. Clustering calculations with time-series similarity metrics indicate the ELM database contains at least two and possibly three groups of ELMs with similar evolution patterns. The identified ELM groups trigger similar stored energy loss, but the groups occupy distinct parameter regimes for ELM-relevant quantities like plasma current, triangularity, and pedestal height. Notably, the pedestal electron pressure gradient is not an effective parameter for distinguishing the ELM groups, but the ELM groups segregate in terms of electron density gradient and electron temperature gradient. The ELM evolution patterns and corresponding parameter regimes can shape the formulation or validation of nonlinear ELM models. Finally, the techniques and results demonstrate an application of unsupervised machine learning at a data-rich fusion facility.Full dataset used as basis for analysis in publication

Midplane neutral density profiles in the National Spherical Torus Experiment

Atomic and molecular density data in the outer midplane of NSTX [Ono et al., Nucl. Fusion 40, 557 (2000)] are inferred from tangential camera data via a forward modeling procedure using the DEGAS 2 Monte Carlo neutral transport code. The observed Balmer-b light emission data from 17 shots during the 2010 NSTX campaign display no obvious trends with discharge parameters such as the divertor Balmer-a emission level or edge deuterium ion density. Simulations of 12 time slices in 7 of these discharges produce molecular densities near the vacuum vessel wall of 2–8 10^17 m3 and atomic densities ranging from 1 to 7 10^16 m3; neither has a clear correlation with other parameters. Validation of the technique, begun in an earlier publication, is continued with an assessment of the sensitivity of the simulated camera image and neutral densities to uncertainties in the data input to the model. The simulated camera image is sensitive to the plasma profiles and virtually nothing else. The neutral densities at the vessel wall depend most strongly on the spatial distribution of the source; simulations with a localized neutral source yield densities within a factor of two of the baseline, uniform source, case. The uncertainties in the neutral densities associated with other model inputs and assumptions are 50%.readme.txt (table of contents), Stotler_PoP.zi

The Dependence of H-mode Energy Confinement and Transport on Collisionality in NSTX

Understanding the dependence of confi nement on collisionality in tokamaks is important for the design of next-step devices, which will operate at collisionalities at least one order of magnitude lower than in present generation. A wide range of collisionality has been obtained in the National Spherical Torus Experiment (NSTX) by employing two different wall conditioning techniques, one with boronization and between-shot helium glow discharge conditioning (HeGDC+B), and one using lithium evaporation (Li EVAP). Previous studies of HeGDC+B plasmas indicated a strong and favorable dependence of normalized con nement on collisionality. Discharges with lithium conditioning discussed in the present study gen- erally achieved lower collisionality, extending the accessible range of collisionality by almost an order of unity. While the confinement dependences on dimensional, engineering variables of the HeGDC+B and Li EVAP datasets differed, collisionality was found to unify the trends, with the lower collisionality lithium conditioned discharges extending the trend of increasing normalized confi nement time with decreasing collisionality when other dimension less variables were held as fi xed as possible. This increase of confi nement with decreasing collisionality was driven by a large reduction in electron transport in the outer region of the plasma. This result is consistent with gyrokinetic calculations that show microtearing and Electron Temperature Gradient modes to be more stable for the lower collisionality discharges. Ion transport, near neoclassical at high collisionality, became more anomalous at lower collisionality, possibly due to the growth of hybrid TEM/KBM modes in the outer regions of the plasma

The Dependence of H-mode Energy Confinement and Transport on Collisionality in NSTX

Understanding the dependence of confi nement on collisionality in tokamaks is important for the design of next-step devices, which will operate at collisionalities at least one order of magnitude lower than in present generation. A wide range of collisionality has been obtained in the National Spherical Torus Experiment (NSTX) by employing two different wall conditioning techniques, one with boronization and between-shot helium glow discharge conditioning (HeGDC+B), and one using lithium evaporation (Li EVAP). Previous studies of HeGDC+B plasmas indicated a strong and favorable dependence of normalized con nement on collisionality. Discharges with lithium conditioning discussed in the present study gen- erally achieved lower collisionality, extending the accessible range of collisionality by almost an order of unity. While the confinement dependences on dimensional, engineering variables of the HeGDC+B and Li EVAP datasets differed, collisionality was found to unify the trends, with the lower collisionality lithium conditioned discharges extending the trend of increasing normalized confi nement time with decreasing collisionality when other dimension less variables were held as fi xed as possible. This increase of confi nement with decreasing collisionality was driven by a large reduction in electron transport in the outer region of the plasma. This result is consistent with gyrokinetic calculations that show microtearing and Electron Temperature Gradient modes to be more stable for the lower collisionality discharges. Ion transport, near neoclassical at high collisionality, became more anomalous at lower collisionality, possibly due to the growth of hybrid TEM/KBM modes in the outer regions of the plasm

Density perturbation mode structure of high frequency compressional and global Alfvén eigenmodes in the National Spherical Torus Experiment using a novel reflectometer analysis technique

Reflectometry measurements of compressional (CAE) and global (GAE) Alfvén eigenmodes are analyzed to obtain the amplitude and spatial structure of the density perturbations associated with the modes. A novel analysis technique developed for this purpose is presented. The analysis also naturally yields the amplitude and spatial structure of the density contour radial displacement, which is found to be 2–4 times larger than the value estimated directly from the reflectometer measurements using the much simpler ‘mirror approximation’. The modes were driven by beam ions in a high power (6 MW) neutral beam heated H-mode discharge (#141398) in the National Spherical Torus Experiment. The results of the analysis are used to assess the contribution of the modes to core energy transport and ion heating. The total displacement amplitude of the modes, which is shown to be larger than previously estimated (Crocker et al 2013 Nucl. Fusion 53 43017), is compared to the predicted threshold (Gorelenkov et al 2010 Nucl. Fusion 50 84012) for the anomalously high heat diffusion inferred from transport modeling in similar NSTX discharges. The results of the analysis also have strong implications for the energy transport via coupling of CAEs to kinetic Alfvén waves seen in simulations with the Hybrid MHD code (Belova et al 2015 Phys. Rev. Lett. 115 15001). Finally, the amplitudes of the observed CAEs fall well below the threshold for causing significant ion heating by stochastic velocity space diffusion (Gates et al 2001 Phys. Rev. Lett. 87 205003).readme, digital data file

Dynamical Evolution of Pedestal Parameters in ELMy H-mode in the National Spherical Torus Experiment

Characterizations of the pedestal parameter dynamics throughout the edge localized modes(ELM) cycles are performed on the National Spherical Torus Experiment (NSTX, [M. Ono et al., Nucl. Fusion 40, 557 (2000)]). A clear buildup of the pedestal height is observed between ELMs for three di erent plasma currents, which tends to saturate prior to the onset of ELM at low and medium plasma current. Similarly, the pedestal width increases with no clear evidence of saturation during an ELM cycle. The maximum pedestal gradient increases as a function of plasma current, reaches a nominal value after the ELM crash, and remains constant until the end of the ELM cycle. The pedestal height just prior to the onset of ELM is shown to increase quadratically with plasma current. The pedestal width Δ is proportional to the square-root of the poloidal Β at the top of the pedestal. Coherent density uctuations strongly increasing at the plasma edge are observed to be maximum after the ELM crash and to decay during the rest of the ELM cycle. Finally, the pedestal parameters evolution during the ELM cycle as well as the scaling with Ip of the pedestal pressure prior to the onset ELM are found to be qualitatively consistent with the peeling ballooning theory